Abstract：
Dry eye disease (DED) is a condition that compromises the ocular surface and affects millions of people around the world. In recent years, a scheme has been proposed for the treatment of DED, with the use of artificial tear being the mainstay of treatment. In this scheme, the use of secretagogues is suggested as part of the treatment for patients with moderate to severe affectation. With this systematic review, we aim to evaluate the effectiveness and safety of secretagogues for DED.
Electronic databases will be searched; we will include randomized controlled trials that compare secretagogues and artificial tears. Study inclusion will not be restricted on the basis of language or publication status. We will use Google Translate to assess studies written in languages other than English and Spanish. Identification, evaluation, data extraction, and assessment of risk of bias will be conducted by two authors of the review, a third review author will resolve any disagreement. The outcomes will be the ocular surface disease index score, tear film break-up time, Schirmer test score, VRQoL Score, and tear film osmolarity. We will use the Cochrane Collaboration Risk of Bias 2 (RoB 2) tool for assessing the risk of bias of the included studies. Based on the heterogeneity of the included studies, we will combine the findings in a meta-analysis using a fixed effect model if heterogeneity ≤ 50% or a random effect model if heterogeneity > 50%. If we deem meta-analysis as inappropriate, we will document the reasons and report findings from the individual studies narratively.
Based on the evidence obtained, we will evaluate the effect of pilocarpine, cevimeline, and diquafosol and compare it to artificial tears on multiple outcome measures. This systematic review aims to determine the efficacy and safety of the secretagogues pilocarpine, cevimeline, and diquafosol to help clinicians in the decision-making process.
PROSPERO CRD42020218407 .
Electronic databases will be searched; we will include randomized controlled trials that compare secretagogues and artificial tears. Study inclusion will not be restricted on the basis of language or publication status. We will use Google Translate to assess studies written in languages other than English and Spanish. Identification, evaluation, data extraction, and assessment of risk of bias will be conducted by two authors of the review, a third review author will resolve any disagreement. The outcomes will be the ocular surface disease index score, tear film break-up time, Schirmer test score, VRQoL Score, and tear film osmolarity. We will use the Cochrane Collaboration Risk of Bias 2 (RoB 2) tool for assessing the risk of bias of the included studies. Based on the heterogeneity of the included studies, we will combine the findings in a meta-analysis using a fixed effect model if heterogeneity ≤ 50% or a random effect model if heterogeneity > 50%. If we deem meta-analysis as inappropriate, we will document the reasons and report findings from the individual studies narratively.
Based on the evidence obtained, we will evaluate the effect of pilocarpine, cevimeline, and diquafosol and compare it to artificial tears on multiple outcome measures. This systematic review aims to determine the efficacy and safety of the secretagogues pilocarpine, cevimeline, and diquafosol to help clinicians in the decision-making process.
PROSPERO CRD42020218407 .
摘要：
干眼症（DED）是一种损害眼表并影响世界各地数百万人的疾病。近年来,已经提出了治疗DED的方案，人工泪液的使用是治疗的主要手段。在这个方案中,建议使用促分泌素作为中度至重度情感障碍患者治疗的一部分。有了这个系统的审查，我们的目标是评估DED的助教的有效性和安全性。
将搜索电子数据库；我们将包括比较促分泌素和人工泪液的随机对照试验。研究纳入将不受语言或出版状态的限制。我们将使用Google翻译来评估用英语和西班牙语以外的语言编写的研究。Identification,评估，数据提取,偏见风险的评估将由审查的两位作者进行，第三篇评论作者将解决任何分歧。结果将是眼表疾病指数评分，泪膜破裂时间,Schirmer考试成绩,VRQoL评分,和泪膜渗透压。我们将使用Cochrane协作偏差风险2（RoB2）工具评估纳入研究的偏差风险。基于纳入研究的异质性，如果异质性≤50%,我们将使用固定效应模型进行荟萃分析,如果异质性>50%,我们将使用随机效应模型进行荟萃分析.如果我们认为荟萃分析不合适，我们将记录原因并以叙述方式报告个别研究的发现。
根据获得的证据，我们将评估毛果芸香碱的效果，Cevimeline,和diquafosol，并将其与人工泪液在多种结果指标上进行比较。本系统评价旨在确定促分泌素毛果芸香碱的疗效和安全性，Cevimeline,和diquafosol帮助临床医生在决策过程中。
PROSPEROCRD42020218407。
将搜索电子数据库；我们将包括比较促分泌素和人工泪液的随机对照试验。研究纳入将不受语言或出版状态的限制。我们将使用Google翻译来评估用英语和西班牙语以外的语言编写的研究。Identification,评估，数据提取,偏见风险的评估将由审查的两位作者进行，第三篇评论作者将解决任何分歧。结果将是眼表疾病指数评分，泪膜破裂时间,Schirmer考试成绩,VRQoL评分,和泪膜渗透压。我们将使用Cochrane协作偏差风险2（RoB2）工具评估纳入研究的偏差风险。基于纳入研究的异质性，如果异质性≤50%,我们将使用固定效应模型进行荟萃分析,如果异质性>50%,我们将使用随机效应模型进行荟萃分析.如果我们认为荟萃分析不合适，我们将记录原因并以叙述方式报告个别研究的发现。
根据获得的证据，我们将评估毛果芸香碱的效果，Cevimeline,和diquafosol，并将其与人工泪液在多种结果指标上进行比较。本系统评价旨在确定促分泌素毛果芸香碱的疗效和安全性，Cevimeline,和diquafosol帮助临床医生在决策过程中。
PROSPEROCRD42020218407。
